Question 1 · Law, Ethics & Human Factors · Easy
A general practitioner who has recently joined a BASICS immediate care scheme asks a colleague how her role fits into the UK system of pre-hospital care. Which statement best describes the position set out in the ABC of Prehospital Emergency Medicine?
- AA regional ambulance service leads, others support it, and specialist teams augment its response
- BImmediate care doctors are the primary tier and task ambulance resources from their own control
- CVoluntary aid societies and immediate care schemes attend only once a major incident is declared
- DPhysician-led teams replace the ambulance response for high-acuity cases, freeing crews for others
- EAir ambulance charities form a separate statutory emergency service with their own command chain
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Answer: A
A regional ambulance service leads, others support it, and specialist teams augment its response
The ABC opens with the model that applies across the developed world: pre-hospital care is usually the responsibility of a regional ambulance or emergency medical service, and a number of agencies may operate in support of it — private ambulance companies, rescue organisations such as mountain rescue and air ambulance services, the voluntary aid societies and immediate care practitioners such as BASICS. The role of the pre-hospital emergency medicine (PHEM) practitioner or team is to augment the existing pre-hospital response, not replace it, adding advanced assessment and critical care on scene and in transfer for patients with higher-acuity illness and injury. The Oxford Handbook adds that ambulance services are NHS trusts, and that air ambulances may be charitably funded while forming part of the ambulance response. Immediate care doctors do not task ambulance resources, their work is not confined to major incidents, and air ambulance charities are not a separate statutory emergency service.
Where this comes from
- ABC of Prehospital Emergency Medicine
- Ch. 1 Prehospital Emergency Medicine · Introduction: the ambulance service and supporting agencies · p. 1“the provision of prehospital care is usually the responsibility of a regional ambulance”
- Ch. 1 Prehospital Emergency Medicine · Introduction: agencies in support of the ambulance service · p. 1“A number of agencies may operate in support of the ambulance service”
- Ch. 1 Prehospital Emergency Medicine · Prehospital emergency medicine: augment, not replace · p. 1“The role of the PHEM practitioner or team is to augment the”
- Oxford Handbook of Pre-Hospital Care
- Ch. 1 An approach to pre-hospital care · The Emergency Services: the Ambulance Service — organization · p. 47“Ambulance services are NHS trusts under the direction of a chief executive.”
- Ch. 1 An approach to pre-hospital care · The Ambulance Service — vehicles and helicopters · pp. 46–48“although air ambulances may also be charitably funded”